DOUGLAS VAN GORIN Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000754

License Status

INACTIVE

Business

First Name

DOUGLAS

Middle

VAN

Last Name

GORIN

Business Name

DOUGLAS VAN GORIN

Original Issue Date

12/13/1972

Effective Date

06/19/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60602

County

COOK

Specialty/Qualifier

Periodontics

Ever Disciplined

LastModifiedDate

06/08/2015